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Heo JS, Kim EK, Kim SY, Song IG, Yoon YM, Cho H, Lee ES, Shin SH, Oh BM, Shin HI, Kim HS. Response to: 'Comment on 'Direct swallowing training and oral sensorimotor stimulation in preterm infants: a randomised controlled trial' by Heo et al' by Harding et al. Arch Dis Child Fetal Neonatal Ed 2023; 108:93-94. [PMID: 35063948 DOI: 10.1136/archdischild-2021-323580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 12/31/2022]
Affiliation(s)
- Ju Sun Heo
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, The Republic of Korea.,Department of Paediatrics, Korea University Anam Hospital, Seoul, The Republic of Korea
| | - Ee-Kyung Kim
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, The Republic of Korea
| | - Sae Yun Kim
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, The Republic of Korea.,Department of Paediatrics, Catholic University of Korea Yeouido Saint Mary's Hospital, Seoul, The Republic of Korea
| | - In Gyu Song
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, The Republic of Korea.,Department of Paediatrics, Korea University Guro Hospital, Seoul, The Republic of Korea
| | - Young Mi Yoon
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, The Republic of Korea.,Department of Paediatrics, Jeju National University Hospital, Jeju, The Republic of Korea
| | - Hannah Cho
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, The Republic of Korea.,Department of Paediatrics, Korea University Anam Hospital, Seoul, The Republic of Korea
| | - Eun Sun Lee
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, The Republic of Korea.,Department of Paediatrics, Chung-Ang University Hospital, Seoul, The Republic of Korea
| | - Seung Han Shin
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, The Republic of Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, The Republic of Korea.,Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Yangpyeong, The Republic of Korea.,Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, The Republic of Korea
| | - Hyung Ik Shin
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, The Republic of Korea.,Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, The Republic of Korea
| | - Han-Suk Kim
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, The Republic of Korea
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Nam SH, Yamano A, Kim JA, Lim J, Baek SH, Kim JE, Kwon TG, Saito Y, Teruya T, Choi SY, Kim YK, Bae YC, Shin HI, Woo JT, Park EK. Prenylflavonoids isolated from Macaranga tanarius stimulate odontoblast differentiation of human dental pulp stem cells and tooth root formation via the mitogen-activated protein kinase and protein kinase B pathways. Int Endod J 2021; 54:1142-1154. [PMID: 33641170 DOI: 10.1111/iej.13503] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 01/09/2023]
Abstract
AIM To identify odontogenesis-promoting compounds and examine the molecular mechanism underlying enhanced odontoblast differentiation and tooth formation. METHODOLOGY Five different nymphaeols, nymphaeol B (NB), isonymphaeol B (INB), nymphaeol A (NA), 3'-geranyl-naringenin (GN) and nymphaeol C (NC) were isolated from the fruit of Macaranga tanarius. The cytotoxic effect of nymphaeols on human DPSCs was observed using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The effect of nymphaeols on odontoblast differentiation was analysed with Alizarin Red S staining and odontoblast marker expression was assessed using real-time polymerase chain reaction and Western blot analysis. The molecular mechanism was investigated with Western blot analysis. In order to examine the effect of INB on dentine formation in the developing tooth germ, INB-soaked beads were placed under the tooth bud explants in the collagen gel; thereafter, the tooth bud explant-bead complexes were implanted into the sub-renal capsules for 3 weeks. Tooth root formation was analysed using micro-computed tomography and histological analysis. Data are presented as mean ± standard error (SEM) values of three independent experiments, and results are compared using a two-tailed Student's t-test. The data were considered to have statistical significance when the P-value was less than 0.05. RESULTS Three of the compounds, NB, INB, and GN, did not exert a cytotoxic effect on human DPSCs. However, INB was most effective in promoting the deposition of calcium minerals in vitro (P < 0.001) and induced the expression of odontogenic marker genes (P < 0.05). Moreover, this compound strongly induced the phosphorylation of mitogen-activated protein (MAP) kinases and protein kinase B (AKT) (P < 0.05). The inhibition of p38 MAP, c-Jun N-terminal kinase (JNK), and AKT substantially suppressed the INB-induced odontoblast differentiation (P < 0.001). In addition, isonymphaeol B significantly induced the formation of dentine and elongation of the tooth root in vivo (P < 0.05). CONCLUSIONS Prenylflavonoids, including INB, exerted stimulatory effects on odontoblast differentiation and tooth root and dentine formation via the MAP kinase and AKT signalling pathways. These results suggest that nymphaeols could stimulate the repair processes for dentine defects or injuries.
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Affiliation(s)
- S H Nam
- Department of Oral Pathology and Regenerative Medicine, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - A Yamano
- Faculty of Education, University of the Ryukyu, Nakagami-gun, Japan
| | - J A Kim
- Department of Oral Pathology and Regenerative Medicine, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - J Lim
- Department of Oral Pathology and Regenerative Medicine, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - S H Baek
- Orthognathic/Oral & Maxillofacial Surgery, Cha & Baek Dental Clinic, Daegu, Korea
| | - J E Kim
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - T G Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Y Saito
- Faculty of Education, University of the Ryukyu, Nakagami-gun, Japan
| | - T Teruya
- Faculty of Education, University of the Ryukyu, Nakagami-gun, Japan
| | - S Y Choi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Y K Kim
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Y C Bae
- Department of Oral Anatomy and Neurobiology, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - H I Shin
- Department of Oral Pathology and Regenerative Medicine, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - J T Woo
- Department of Biological Chemistry, College of Bioscience and Biotechnology, Chubu University, Kasugai, Japan
| | - E K Park
- Department of Oral Pathology and Regenerative Medicine, School of Dentistry, Kyungpook National University, Daegu, Korea
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Kim C, Sung J, Lee JH, Kim WS, Lee GJ, Jee S, Jung IY, Rah UW, Kim BO, Choi KH, Kwon BS, Yoo SD, Bang HJ, Shin HI, Kim YW, Jung H, Kim EJ, Lee JH, Jung IH, Jung JS, Lee JY, Han JY, Han EY, Won YH, Han W, Baek S, Joa KL, Lee SJ, Kim AR, Lee SY, Kim J, Choi HE, Lee BJ, Kim S. Clinical Practice Guideline for Cardiac Rehabilitation in Korea: Recommendations for Cardiac Rehabilitation and Secondary Prevention after Acute Coronary Syndrome. Korean Circ J 2019; 49:1066-1111. [PMID: 31646772 PMCID: PMC6813162 DOI: 10.4070/kcj.2019.0194] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 08/23/2019] [Indexed: 02/07/2023] Open
Abstract
Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular (CV) disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of thirty-three authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers CV mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.
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Affiliation(s)
- Chul Kim
- Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University School of Medicine, Seoul, Korea
| | - Jidong Sung
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine-Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Korea
| | - Jong Hwa Lee
- Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine-Regional Cardiocerebrovascular Center, Dong-A Medical Center, Busan, Korea
| | - Won Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Gyeonggi Regional Cardiocerebrovascular Center, Seongnam, Korea
| | - Goo Joo Lee
- Department of Rehabilitation Medicine, Chungbuk National University Hospital, Chungbuk Regional Cardiocerebrovascular Center, Chungbuk National University College of Medicine, Cheongju, Korea.
| | - Sungju Jee
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine-Daejeon Chungcheong Regional Cardiocerebrovascular Center, Chugnam National University Hospital, Daejeon, Korea
| | - Il Young Jung
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine-Daejeon Chungcheong Regional Cardiocerebrovascular Center, Chugnam National University Hospital, Daejeon, Korea
| | - Ueon Woo Rah
- Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Korea
| | - Byung Ok Kim
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University School of Medicine, Seoul, Korea
| | - Kyoung Hyo Choi
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bum Sun Kwon
- Department of Rehabilitation Medicine, Dongguk University School of Medicine, Goyang, Korea
| | - Seung Don Yoo
- Department of Rehabilitation Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Heui Je Bang
- Department of Rehabilitation Medicine, Chungbuk National University Hospital, Chungbuk Regional Cardiocerebrovascular Center, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hyung Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Wook Kim
- Department and Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Heeyoune Jung
- National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
| | - Eung Ju Kim
- Division of Cardiology, Department of Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | | | - In Hyun Jung
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University School of Medicine, Seoul, Korea
| | - Jae Seung Jung
- Department of Thoracic and Cardiovascular Surgery, Anam Hospital, Korea University Medical Center, Seoul, Korea
| | - Jong Young Lee
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Young Han
- Department of Rehabilitation Medicine, Gwangju-Jeonnam Regional Cardiocerebrovascular Center, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - Eun Young Han
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Yu Hui Won
- Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Woosik Han
- Department of Thoracic Surgery, Chungnam National University Hospital, Daejeon, Korea
| | - Sora Baek
- Department of Rehabilitation Medicine, Kangwon National University School of Medicine-Kangwon Regional Cardiocerebrovascular Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Kyung Lim Joa
- Department of Rehabilitation Medicine, Inha University Hospital, Incheon, Korea
| | - Sook Joung Lee
- Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Ae Ryoung Kim
- Department of Rehabilitation Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - So Young Lee
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Jihee Kim
- Department of Rehabilitation Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
| | - Hee Eun Choi
- Department of Physical Medicine and Rehabilitation, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Byeong Ju Lee
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Korea
| | - Soon Kim
- Research Institute for Social Science, Ewha Woman's University, Seoul, Korea
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Kim WS, Bae HJ, Lee HH, Shin HI. Status of Rehabilitation After Ischemic Stroke: A Korean Nationwide Study. Ann Rehabil Med 2018; 42:528-535. [PMID: 30180521 PMCID: PMC6129701 DOI: 10.5535/arm.2018.42.4.528] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 09/26/2017] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To investigate the post-stroke rehabilitation status according to stroke severity using the database of the Korean Health Insurance Review and Assessment Service. METHODS The data of patients admitted to the neurology departments of 12 hospitals within 7 days of onset of ischemic stroke were collected. A total of 2,895 patients hospitalized between November 2010 and December 2011 were included. The patients were classified into three groups according to their initial National Institutes of Health Stroke Scale (NIHSS) scores (mild, ≤5; moderate, >5 and ≤13; and severe, >13). Length of hospital stay (LoS) with rehabilitation, NIHSS score after acute care, and scores on modified Rankin Scale (mRS) were examined at 1 year post-stroke according to stroke severity and ongoing rehabilitation. RESULTS The total LoS for ongoing rehabilitation significantly increased with stroke severity (mild, 91.66±149.70; moderate, 197.26±241.93; severe, 263.50±275.75 days; p<0.01). However, the proportion of LoS with ongoing rehabilitation to the total LoS tended to decline with increasing stroke severity (mild, 77.93±29.50, p<0.01; moderate, 71.83±32.13; severe, 62.29±37.19). The home discharge rate of the group that underwent continuous inpatient rehabilitation was significantly higher in patients with moderate and severe stroke, respectively (14.2% vs. 0.0%, p<0.001; 7.4% vs. 0.0%, p=0.032). CONCLUSION This study showed that intermittent rehabilitation was often provided after acute care, whereas ongoing rehabilitation positively affected rate of home discharge in patients with moderate and severe stroke in Korea. These results represent evidence for improving the healthcare system to promote adequate rehabilitation in the future.
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Affiliation(s)
- Won-Sep Kim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyun-Haeng Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hyung Ik Shin
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
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Chun SM, Kim HR, Shin HI. Estimating the Basal metabolic rate from fat free mass in individuals with motor complete spinal cord injury. Spinal Cord 2017; 55:844-847. [DOI: 10.1038/sc.2017.53] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 04/06/2017] [Accepted: 04/06/2017] [Indexed: 11/09/2022]
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Oh MK, Kim HR, Kim WS, Shin HI. Relationship Between Motor Evoked Potential Response and the Severity of Paralysis in Spinal Cord Injury Patients. Ann Rehabil Med 2017; 41:211-217. [PMID: 28503453 PMCID: PMC5426257 DOI: 10.5535/arm.2017.41.2.211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 08/23/2016] [Indexed: 11/12/2022] Open
Abstract
Objective To investigate the relationship between motor evoked potential (MEP) response and the severity of motor paralysis, evaluated according to the Korean disability evaluation system in patients with spinal cord injury (SCI). Methods We analyzed 192 lower limbs of 96 SCI patients. Lower limbs were classified according to their motor scores, as determined by the International Standards for Neurological Classification of Spinal Cord Injury: motor score <10 (group 1); ≥10 and <15 (group 2); ≥15 and <20 (group 3); and ≥20 (group 4). MEP responses were classified as ‘normal’, ‘delayed’ or ‘absent’, based on their onset latency, which was compared between the different motor score groups. Results MEP responses and limb motor scores were highly correlated (p<0.001). There was a significant difference of MEP responses between the motor score groups (p<0.001). MEP response was markedly poorer in motor group 1 (limb motor score <10) than in the other three groups (p<0.0001). However, there were no differences between the three groups with motor scores of 10 or above. Conclusion Clinical utility of MEP as a complimentary tool to manual muscle tests could be limited to discriminating motor score groups with severe paralysis, i.e., single lower limb motor power grades of 0 or 1, and from grade 2, 3, and 4, or above, in the Korean disability evaluation system.
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Affiliation(s)
- Mi-Kyoung Oh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hye-Ri Kim
- Department of Rehabilitation Medicine, National Rehabilitation Hospital, Seoul, Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hyung Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Kang JH, Bae HJ, Choi YA, Lee SH, Shin HI. Length of Hospital Stay After Stroke: A Korean Nationwide Study. Ann Rehabil Med 2016; 40:675-81. [PMID: 27606274 PMCID: PMC5012979 DOI: 10.5535/arm.2016.40.4.675] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 01/05/2016] [Indexed: 11/26/2022] Open
Abstract
Objective To investigate the length of hospital stay (LOS) after stroke using the database of the Korean Health Insurance Review & Assessment Service. Methods We matched the data of patients admitted for ischemic stroke onset within 7 days in the Departments of Neurology of 12 hospitals to the data from the database of the Korean Health Insurance Review & Assessment Service. We recruited 3,839 patients who were hospitalized between January 2011 and December 2011, had a previous modified Rankin Scale of 0, and no acute hospital readmission after discharge. The patients were divided according to the initial National Institute of Health Stroke Scale score (mild, ≤5; moderate, >5 and ≤13; severe, >13); we compared the number of hospitals that admitted patients and LOS after stroke according to severity, age, and sex. Results The mean LOS was 115.6±219.0 days (median, 19.4 days) and the mean number of hospitals was 3.3±2.1 (median, 2.0). LOS was longer in patients with severe stroke (mild, 65.1±146.7 days; moderate, 223.1±286.0 days; and severe, 313.2±336.8 days). The number of admitting hospitals was greater for severe stroke (mild, 2.9±1.7; moderate, 4.3±2.6; and severe, 4.5±2.4). LOS was longer in women and shorter in patients less than 65 years of age. Conclusion LOS after stroke differed according to the stroke severity, sex, and age. These results will be useful in determining the appropriate LOS after stroke in the Korean medical system.
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Affiliation(s)
- Ji-Ho Kang
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young-Ah Choi
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Heon Lee
- Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea
| | - Hyung Ik Shin
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
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Shin HI, Sung KH, Chung CY, Lee KM, Lee SY, Lee IH, Park MS. Relationships between Isometric Muscle Strength, Gait Parameters, and Gross Motor Function Measure in Patients with Cerebral Palsy. Yonsei Med J 2016; 57:217-24. [PMID: 26632404 PMCID: PMC4696956 DOI: 10.3349/ymj.2016.57.1.217] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 04/07/2015] [Accepted: 05/28/2015] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study investigated the correlation between isometric muscle strength, gross motor function, and gait parameters in patients with spastic cerebral palsy and to find which muscle groups play an important role for gait pattern in a flexed knee gait. MATERIALS AND METHODS Twenty-four ambulatory patients (mean age, 10.0 years) with spastic cerebral palsy who were scheduled for single event multilevel surgery, including distal hamstring lengthening, were included. Preoperatively, peak isometric muscle strength was measured for the hip flexor, hip extensor, knee flexor, and knee extensor muscle groups using a handheld dynamometer, and three-dimensional (3D) gait analysis and gross motor function measure (GMFM) scoring were also performed. Correlations between peak isometric strength and GMFM, gait kinematics, and gait kinetics were analyzed. RESULTS Peak isometric muscle strength of all muscle groups was not related to the GMFM score and the gross motor function classification system level. Peak isometric strength of the hip extensor and knee extensor was significantly correlated with the mean pelvic tilt (r=-0.588, p=0.003 and r=-0.436, p=0.033) and maximum pelvic obliquity (r=-0.450, p=0.031 and r=-0.419, p=0.041). There were significant correlations between peak isometric strength of the knee extensor and peak knee extensor moment in early stance (r=0.467, p=0.021) and in terminal stance (r=0.416, p=0.043). CONCLUSION There is no correlation between muscle strength and gross motor function. However, this study showed that muscle strength, especially of the extensor muscle group of the hip and knee joints, might play a critical role in gait by stabilizing pelvic motion and decreasing energy consumption in a flexed knee gait.
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Affiliation(s)
- Hyung Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ki Hyuk Sung
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chin Youb Chung
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyoung Min Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seung Yeol Lee
- Department of Orthopaedic Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - In Hyeok Lee
- Department of Orthopaedic Surgery, Sungkyunkwan University Samsung Changwon Hospital, Changwon, Korea
| | - Moon Seok Park
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
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Choi YA, Kang JH, Shin HI. Sexual activity and sexual satisfaction in Korean men with spinal cord injury. Spinal Cord 2015; 53:697-700. [DOI: 10.1038/sc.2015.55] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 02/08/2015] [Accepted: 02/25/2015] [Indexed: 11/09/2022]
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Yoon EJ, Kim YK, Shin HI, Lee Y, Kim SE. Cortical and white matter alterations in patients with neuropathic pain after spinal cord injury. Brain Res 2013; 1540:64-73. [DOI: 10.1016/j.brainres.2013.10.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 09/27/2013] [Accepted: 10/04/2013] [Indexed: 01/18/2023]
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Yoon EJ, Kim YK, Kim HR, Kim SE, Lee Y, Shin HI. Transcranial Direct Current Stimulation to Lessen Neuropathic Pain After Spinal Cord Injury. Neurorehabil Neural Repair 2013; 28:250-9. [DOI: 10.1177/1545968313507632] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background. It is suggested that transcranial direct current stimulation (tDCS) can produce lasting changes in corticospinal excitability and can potentially be used for the treatment of neuropathic pain. However, the detailed mechanisms underlying the effects of tDCS are unknown. Objective. We investigated the underlying neural mechanisms of tDCS for chronic pain relief using [18F]-fluorodeoxyglucose positron emission tomography ([18F]FDG-PET). Methods. Sixteen patients with neuropathic pain (mean age 44.1 ± 8.6 years, 4 females) due to traumatic spinal cord injury received sham or active anodal stimulation of the motor cortex using tDCS for 10 days (20 minutes, 2 mA, twice a day). The effect of tDCS on regional cerebral glucose metabolism was evaluated by [18F]FDG-PET before and after tDCS sessions. Results. There was a significant decrease in the numeric rating scale scores for pain, from 7.6 ± 0.5 at baseline to 5.9 ± 1.8 after active tDCS ( P = .016). We found increased metabolism in the medulla and decreased metabolism in the left dorsolateral prefrontal cortex after active tDCS treatment compared with the changes induced by sham tDCS. Additionally, an increase in metabolism after active tDCS was observed in the subgenual anterior cingulate cortex and insula. Conclusion. The results of this study suggest that anodal stimulation of the motor cortex using tDCS can modulate emotional and cognitive components of pain and normalize excessive attention to pain and pain-related information.
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Affiliation(s)
- Eun Jin Yoon
- Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Seoul National University Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Yu Kyeong Kim
- Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Seoul National University Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Hye-Ri Kim
- Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Sang Eun Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea
- Seoul National University Medical Research Center, Seoul National University, Seoul, Republic of Korea
- Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Youngjo Lee
- Seoul National University, Seoul, Republic of Korea
| | - Hyung Ik Shin
- Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
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12
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Kim YH, Kwon CH, Shin HI. Validity of motor impairment scale in long-term care insurance system of Korea. Ann Rehabil Med 2013; 37:403-12. [PMID: 23869339 PMCID: PMC3713298 DOI: 10.5535/arm.2013.37.3.403] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 02/22/2013] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To validate the Motor Impairment Scale (MIS) of the Korean long-term care insurance (LTCI) system by comparing with the service time offered for aiding activities of daily living (ADL) and the ADL score. METHODS A total of 407 elderly subjects without dementia who had used LTCI services were included in this study. Spearman correlations and multivariate linear regression models were employed to determine the relationship of the upper and lower limb MIS (U-MIS and L-MIS, respectively) to the service time and ADL. Stratified analyses for the facility group (n=121) and the domiciliary group (n=286) were performed. RESULTS There were significant differences in characteristics between facility group and domiciliary group. The MIS was significantly correlated with service time in facility group (Spearman p=0.41 for U-MIS, Spearman p=0.40 for L-MIS). After adjusting for age, sex, and cognition score, U-MIS was an independent predictor for service time in facility group (p=0.04). In domiciliary group, no significant correlation was found between the MIS and service time. The MIS correlated with all of the ADL items and total ADL score in both groups. After adjusting for other factors including age, sex, and cognitive score, U-MIS and L-MIS were independent variables for explaining the total ADL score in both groups. CONCLUSION The validity of the MIS as an evaluation tool in the physically-disabled elderly is higher in facility group than in domiciliary group. As an easy, objective, and simple method, MIS can be a useful tool in the LTCI system of Korea.
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Affiliation(s)
- Yeo Hyung Kim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
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13
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Abstract
Objective To investigate the characteristics of community-dwelling spinal cord injury (SCI) persons with obesity, including diet, socioeconomic factors, weight reduction method, and frequency of body weight and abdominal circumference measurements. Methods We developed a questionnaire based on 'the Fourth Korea National Health and Nutrition Examination Survey, 2009'. A total of 371 community-dwelling SCI persons were enrolled in this study. Inclusion criteria were SCI persons older than 20 years with more than 1 year elapsed since the injury. Trained investigators visited SCI persons' home to complete the questionnaire and measure abdominal obesity (AO) as defined by the waist circumference. Results Prevalence of AO was 29.2% in SCI persons and 27.4% in the general population (GP), showing no significant difference. Education showed correlation with AO in both SCI persons and the GP. The injury level, type of injury and income did not show any correlation with AO in SCI persons. Only 28.8% and 48.8% of SCI persons measured their waist circumference and body weight within the past year, respectively. Also, SCI persons with AO thought that their body was less obese compared to persons with AO in the GP (p<0.001). The method of weight reduction was diet modification in 53.6% of SCI persons with AO, which was higher than 37.1% of persons with AO in the GP. Conclusion In SCI persons, obesity perception as well as socioeconomic factors correlated with AO, but these were not relevant factors in the GP. Therefore, development of a specific and intensive weight control program for SCI persons is necessary.
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Affiliation(s)
- Kwang Dong Kim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
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14
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Abstract
Objective To evaluate the feasibility of the ICF for initial comprehensive evaluation of early post-acute spinal cord injury. Method A comprehensive evaluation of 62 early post-acute spinal cord injury (SCI) patients was conducted by rehabilitation team members, such as physicians, physical therapists, occupational therapists, nutritionists, medical social-workers, and nurses. They recorded each of their evaluation according to the ICF first level classification. The contents of the comprehensive evaluation were linked to the ICF second level categories, retrospectively. The linked codes were analyzed descriptively and were also compared with the brief ICF core set for early post-acute SCI. Results In the evaluation of early post-acute SCI patients based on the ICF first level categories, 19 items from the body functions domain, such as muscle power functions (b730) and urination functions (b620), 15 items from the body structures domain, including spinal cord and related structures (s120), 11 items from the activities and participation domain, such as transferring oneself (d420) and walking (d450), and 9 items from the environmental factors domain, e.g., health professionals (e355), were linked to the ICF second level categories. In total, 82.4% of all contents were linked to the brief ICF core set. Prognosis insight, a personal factor not linkable to an ICF code, was mentioned in 29.0% of all patients. Conclusion First level ICF categories can provide a structural base for a comprehensive evaluation in early post-acute spinal cord injury. However, frequently linked items, including the brief core set, as well as personal factors should be considered via a checklist in order to prevent the omission of significant contents.
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Affiliation(s)
- Hyung Seok Nam
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul 110-744, Korea
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15
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Kim HR, Lee BS, Lee JE, Shin HI. Application of transanal irrigation for patients with spinal cord injury in South Korea: a 6-month follow-up study. Spinal Cord 2013; 51:389-94. [PMID: 23318554 DOI: 10.1038/sc.2012.171] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
STUDY DESIGN A 6-month follow-up study. OBJECTIVES To investigate the outcome of transanal irrigation (TAI) in patients with spinal cord injury (SCI) and to identify factors significantly related to clinical success. SETTING Survey for community-dwelling patients with SCI in South Korea. METHODS Between December 2010 and March 2012, TAI was initiated with 52 patients (41 men; age: 44.5±11.0 years) with neurogenic bowel dysfunction (NBD). At 1, 3 and 6 months after initiation, a telephone interview was conducted. Data were collected on patient-specific bowel management and TAI performance as a new procedure. RESULTS Only 18 patients (34%) used TAI for at least 6 months, which was a lower compliance rate than similar studies in some European countries. Relative to the compliant group, the noncompliant group contained a higher proportion of tetraplegia than paraplegia (P=0.031), and a higher proportion dependent on physical help (P=0.034). In all, 33 of the 52 patients (63.5%) complained of practical problems with the TAI procedure such as expulsion of the rectal catheter. Fifteen patients (28.8%) presented with adverse effects. The incidence of practical problems or adverse effects did not alter the frequency of patient-reported successful outcome. CONCLUSION Korean participants showed a relatively lower compliance rate with TAI. We conclude that TAI, combined with adequate patient instruction and physical assistance, has potential as a management tool for NBD in Korea.
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Affiliation(s)
- H R Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea
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16
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Yang EJ, Kim BR, Shin HI, Lim JY. Use of the international classification of functioning, disability and health as a functional assessment tool for breast cancer survivors. J Breast Cancer 2012; 15:43-50. [PMID: 22493627 PMCID: PMC3318173 DOI: 10.4048/jbc.2012.15.1.43] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 02/16/2012] [Indexed: 11/30/2022] Open
Abstract
Purpose To develop a patient self-completed questionnaire from the items of the Brief Core Set Questionnaire for Breast Cancer (BCSQ-BC) and to investigate the prevalence of specific dysfunctions throughout the course of cancer and treatments. Methods From January 2010 to February 2011, 96 breast cancer patients were evaluated with BCSQ-BC developed for clinical application of International Classification of Functioning, Disability and Health (ICF). Quality of life and upper limb dysfunction using disabilities of arm, shoulder and hand (DASH) were assessed. Content validity was evaluated using correlations between BCSQ-BC and European Organization for Research and Treatment of Cancer (EORTC) QLQ and DASH scores. Construct validity was computed using exploratory factor analysis. Kappa statistics were computed for agreement between test-retest ICF data. The level of significance and odds ratios were reported for individuals with early post-acute and long-term context and with total mastectomy and breast conservative surgery. Results There was
consistently good test-retest agreement in patient-completed questionnaires (kappa value, 0.76). Body function, activity and participation subscales are significantly related with EORTC QLQ and DASH. Problems with activity and participation were strongly associated with physical functional domains of EORTC QLQ (r=-0.708, p<0.001) and DASH (r=0.761, p<0.001). The prevalence of dysfunctions varied with type of surgery and time after cancer. Immobility of joint (15% vs. 7%) and lymphatic dysfunction (17% vs. 3%) were indexed more frequently in extensive surgery cases than in conservative surgery. Muscle power (16% vs. 8%), exercise tolerance functions (12% vs. 4%) and looking after one's health (10% vs. 2%) were impaired within 1 year after surgery, while sleep dysfunction (8% vs. 14%) was a major problem over 1 year after surgery. Conclusion The BCSQ-BC identifies the problems comprehensively in functioning of patients with breast cancer. We revealed the interaction with the ICF framework adopting a multifactor understanding of function and disability.
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Affiliation(s)
- Eun Joo Yang
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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17
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Abstract
PURPOSE Although later-onset disability has been associated with poor self-rated health (SRH), factors mediating differences in SRH related to age at onset of disability remain unclear. The present study was designed to identify the variables explaining poor SRH in later-onset disability. We examined chronic disease and functional status as alternatives to psychosocial adaptation as explanatory variables. METHOD Our data were taken from the seventh National Survey for People with Disabilities among Korean individuals ≥18 years of age (n =5311). RESULTS Those with later-onset disability (onset ages 20-40, 41-64 and ≥65 years) showed higher age-adjusted odds ratios (ORs) for poor SRH compared with those with earlier-onset disability (onset ages 0-19 years). The ORs for poor SRH in individuals with later-onset disability were not substantially changed after adjusting for confounding variables including alternatives to psychosocial adaptation (chronic diseases and functional status) as explanatory variables. CONCLUSIONS Failure to explain poor SRH in later-onset disability with explanatory variables other than psychosocial adaptation indirectly supports the role of psychosocial adaptation in differences in SRH related to age at onset. Because we could not include appropriate measures of psychosocial adaptation, the use of additional instruments should be considered in future studies.
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Affiliation(s)
- Won-Seok Kim
- Graduate School of Public Health, Seoul National University, Korea
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18
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Abstract
PURPOSE In cases of complete spinal cord injury (SCI), which has a poor probability of recovery, the timely delivery of a prognosis may be crucial to help patients adapt to their situation. The study aimed to help for choose the appropriate time for delivering a prognosis to persons with SCI. METHOD Three hundred and four members of the Korean SCI Association with complete SCI were surveyed regarding the time at which their prognosis was communicated and their views about the appropriate time for prognosis delivery. Demographic and injury characteristics were also collected. Respondents' experience and opinions on prognosis communication were analysed to assess potential associations with demographic and injury profiles. RESULTS Participants' opinions regarding the time of prognosis delivery varied. Many respondents (44.1%) reported that the appropriate time would be within 1 month postinjury, whereas the others felt it should occur either between 1 and 3 months (29.3%) or more than 3 months (10.2%). The comparison of time of prognosis communication with the opinions showed that most would have preferred an earlier delivery of prognosis than they had experienced. CONCLUSIONS Our findings provide insight to physicians on the appropriate time for delivering a prognosis to individuals with complete SCI.
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Affiliation(s)
- Hye-Ri Kim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Republic of Korea
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Jang JY, Park EK, Ryoo HM, Shin HI, Kim TH, Jang JS, Park HS, Choi JY, Kwon TG. Polymorphisms in the Matrilin-1 gene and risk of mandibular prognathism in Koreans. J Dent Res 2010; 89:1203-7. [PMID: 20739701 DOI: 10.1177/0022034510375962] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Previous linkage analysis of an Asian population proposed possible candidate genes for mandibular prognathism, such as Matrilin-1 (cartilage matrix protein). To investigate the association between the single-nucleotide polymorphisms (SNPs) in Matrilin-1 and mandibular prognathism, we investigated three sequence variants (-158 T>C, 7987 G>A, 8572 C>T) in 164 mandibular prognathism patients and 132 control individuals with a normal occlusion. The results showed that the 8572 TT genotypes in Matrilin-1 showed increased risk of mandibular prognathism (OR = 9.28, 95% Cl = 1.19~197.57, P < 0.05), whereas the 7987 AA genotype showed a protective effect for mandibular prognathism (OR = 0.16, 95% Cl = 0.05~0.47, P < 0.05). Genotyping results showed that the Matrilin-1 polymorphism haplotype TGC (ht4; 158T, 7987G, and 8572C alleles) had a pronounced risk effect for mandibular prognathism compared with controls (OR = 5.16, 95% Cl = 2.03~13.93, P < 0.01). The results suggest that polymorphisms in Matrilin-1 could be used as a marker for genetic susceptibility to mandibular prognathism.
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Affiliation(s)
- J Y Jang
- Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Samduck 2 Ga, Jung Gu, Daegu, 700-412, Korea
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20
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Lee JW, Shin HI, Park SY, Lee GY, Kang HS. Therapeutic trial of fluoroscopic interlaminar epidural steroid injection for axial low back pain: effectiveness and outcome predictors. AJNR Am J Neuroradiol 2010; 31:1817-23. [PMID: 20616178 DOI: 10.3174/ajnr.a2180] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE An ESI for managing LBP is one of the most commonly performed interventions. The purpose of this observational study was to assess the effect of a therapeutic trial of a fluoroscopic interlaminar ESI for axial LBP and to analyze the outcome predictors. MATERIALS AND METHODS All patients who received an interlaminar ESI for axial LBP at our facility in 2007 and 2008 were included. Initial short-term follow-up was done at <1 month after ESI. ESI was considered effective if patients had a reduction of >50% in their pain scores. In July 2009, telephone interviews were conducted by using formatted questions including the NASS patient-satisfaction index. The symptom-free interval was computed by the Kaplan-Meier method. Outcome predictors such as age, sex, duration of LBP, and MR imaging findings were statistically analyzed by the Mann-Whitney U and the Fisher exact tests. RESULTS Eighty-one patients (male/female = 16:65; mean age, 49.9 years; range, 17-77 years) were included in the study. The interlaminar ESI was effective in 63 of the 81 patients (77.8%) at initial short-term follow-up. For the 63 patients in whom ESI was effective, the median symptom-free interval was 154 days (95% CI, 96-212 days). Among 68 patients for whom telephone interviews were possible, 44 patients (64.7%) replied positively to the NASS patient satisfaction index (NASS patient-satisfaction index, 1 or 2). There were no significant outcome predictors. CONCLUSIONS The therapeutic trial of a fluoroscopic interlaminar ESI was effective for axial LBP without significant outcome predictors.
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Affiliation(s)
- J W Lee
- Departments of Radiology, Seoul National University Bundang Hospital, Gyeongi-Do, Korea
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21
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Kang BS, Shin HI, Bang MS. Effect of repetitive transcranial magnetic stimulation over the hand motor cortical area on central pain after spinal cord injury. Arch Phys Med Rehabil 2009; 90:1766-71. [PMID: 19801069 DOI: 10.1016/j.apmr.2009.04.008] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Revised: 04/22/2009] [Accepted: 04/27/2009] [Indexed: 12/31/2022]
Abstract
UNLABELLED Kang BS, Shin HI, Bang MS. Effect of repetitive transcranial magnetic stimulation over the hand motor cortical area on central pain after spinal cord injury. OBJECTIVE To evaluate the analgesic effect of repetitive transcranial magnetic stimulation (rTMS) applied on the hand motor cortical area in patients with spinal cord injury (SCI) who have chronic neuropathic pain at multiple sites in the body, including the lower limbs, trunk, and pelvis. DESIGN Blinded, randomized crossover study. SETTING University hospital outpatient setting. PARTICIPANTS Patients (N=13) with motor complete or incomplete SCI and chronic central pain (11 completed the study). INTERVENTIONS rTMS was applied on the hand motor cortical area using a figure-of-eight coil. One thousand stimuli were applied daily on 5 consecutive days. Real and sham rTMS were separated by 12 weeks. MAIN OUTCOME MEASURES Numeric rating scale (NRS) for average and worst pain and the Brief Pain Inventory (BPI). RESULTS At 1 week after the end of the rTMS period, the average NRS scores changed from 6.45+/-2.25 to 5.45+/-1.81 with real stimulation and from 6.18+/-1.83 to 5.91+/-2.07 with sham stimulation, and did not differ between treatments. The interference items of the BPI also did not differ between the real and sham rTMS. The effect of time on the NRS score for worst pain was significant with real stimulation but not with sham stimulation. CONCLUSIONS The therapeutic efficacy of rTMS was not demonstrated when rTMS was applied to the hand motor cortical area in patients with chronic neuropathic pain at multiple sites in the body, including the lower limbs, trunk, and pelvis. However, the results for worst pain reduction suggest that further studies are required in which rTMS is applied with a more intensive stimulation protocol.
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Affiliation(s)
- Bo Sung Kang
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, South Korea
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22
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Yoon EJ, Kim YK, Lee HS, Shin HI, KIM SE. Evaluation of tDCS effect on regional cerebral glucose metabolism in patients with central pain. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70628-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Calvi LM, Shin HI, Knight MC, Weber JM, Young MF, Giovannetti A, Schipani E. Constitutively active PTH/PTHrP receptor in odontoblasts alters odontoblast and ameloblast function and maturation. Mech Dev 2005; 121:397-408. [PMID: 15110049 DOI: 10.1016/j.mod.2004.02.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2003] [Revised: 01/28/2004] [Accepted: 02/02/2004] [Indexed: 11/15/2022]
Abstract
Parathyroid hormone (PTH)-related protein (PTH-rP) is an important autocrine/paracrine attenuator of programmed cell differentiation whose expression is restricted to the epithelial layer in tooth development. The PTH/PTHrP receptor (PPR) mRNA in contrast is detected in the dental papilla, suggesting that PTHrP and the PPR may modulate epithelial-mesenchymal interactions. To explore the possible interactions, we studied the previously described transgenic mice in which a constitutively active PPR is targeted to osteoblastic cells. These transgenic mice have a vivid postnatal bone and tooth phenotype, with normal tooth eruption but abnormal, widened crowns. Transgene mRNA expression was first detected at birth in the dental papilla and, at 1 week postnatally, in odontoblasts. There was no transgene expression in ameloblasts or in other epithelial structures. Prenatally, transgenic molars and incisors revealed no remarkable change. By the age of 1 week, the dental papilla was widened, with disorganization of the odontoblastic layer and decreased dentin matrix. In addition, the number of cusps was abnormally increased, the ameloblastic layer disorganized, and enamel matrix decreased. Odontoblastic and, surprisingly, ameloblastic cytodifferentiation was impaired, as shown by in situ hybridization and electron microscopy. Interestingly, ameloblastic expression of Sonic Hedgehog, a major determinant of ameloblastic cytodifferentiation, was dramatically altered in the transgenic molars. These data suggest that odontoblastic activation of the PPR may play an important role in terminal odontoblastic and, indirectly, ameloblastic cytodifferentiation, and describe a useful model to study how this novel action of the PPR may modulate mesenchymal/epithelial interactions at later stages of tooth morphogenesis and development.
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Affiliation(s)
- L M Calvi
- Endocrine Unit, Department of Medicine, University of Rochester School of Medicine, Rochester, NY, USA
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Abstract
OBJECTIVE To evaluate the gait patterns of lower limb amputee patients walking with and without shoes and to identify differences in barefoot gait patterns when using different prosthetic feet. DESIGN Optoelectronic three-dimensional motion analysis of gait was performed on six transtibial amputees using a solid ankle cushion heel foot and a single-axis foot, both with and without shoes. RESULTS Gait abnormalities were observed during barefoot walking when the solid ankle cushion heel foot was used. These included knee joint hyperextension of 9.9 +/- 2.0 degrees and the loss of ankle plantar flexion in the early stance phase. When the single-axis foot was used, knee flexion thrust declined from 9.9 +/- 3.7 degrees to 7.2 +/- 3.8 degrees and ankle plantar flexion decreased from 9.9 +/- 2.8 degrees to 7.0 +/- 2.1 degrees during the early stance phase. CONCLUSIONS In transtibial amputees, significant gait abnormalities were observed during barefoot walking using the solid ankle cushion heel foot. These gait patterns improved, however, with use of a single-axis prosthetic foot, which permits a further plantar flexion after the initial contact.
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Affiliation(s)
- Tai Ryoon Han
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Korea
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Abstract
Runx2 (previously known as Cbfal/Pebp2alphaA/AML3), a key transcription factor in osteoblast differentiation, has at least two different isoforms using alternative promoters, which suggests that the isoforms might be expressed differentially. Haploinsufficiency of the Runx2 gene is associated with cleidocranial dysplasia (CCD), the main phenotype of which is inadequate development of calvaria. In spite of the biological relevance, Runx2 gene expression patterns in developing calvaria has not been explored previously, and toward this aim we developed three probes: pRunx2, which comprises the common coding sequence of Runx2 and hybridizes with all isoforms; pPebp2alphaA, which specifically hybridizes with the isoform transcribed with the proximal promoter; and pOsf2, which hybridizes with the isoform transcribed with the distal promoter. These probes were hybridized with tissue sections of mouse calvaria taken at various time points in development. Runx2 expression was localized to the critical area of cranial suture closure, being found in parietal bones, osteogenic fronts, and sutural mesenchyme. Pebp2alphaA and Osf2 showed tissue-specific expression patterns. The sites of Pebp2alphaA expression were almost identical to that of pRunx2 hybridization but expression was most intense in the sutural mesenchyme, where undifferentiated mesenchymal cells reside. The Osf2 isoform was strongly expressed in the osteogenic fronts, as well as in developing parietal bones, where osteopontin (OP) and osteocalcin (OC) also were expressed. However, in contrast to Pebp2alphaA, Osf2 expression did not occur in sutural mesenchyme. Pebp2alphaA also was expressed prominently in primordial cartilage that is found under the sutural mesenchyme and is not destined to be mineralized. Thus, Osf2 isoforms contribute to events later in osteoblast differentiation whereas the Pebp2alphaA isoform participates in a wide variety of cellular activities ranging from early stages of osteoblast differentiation to the final differentiation of osteoblasts.
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Affiliation(s)
- M H Park
- Department of Biochemistry, School of Dentistry, Kyungpook National University, Taegu, Korea
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Lee MH, Javed A, Kim HJ, Shin HI, Gutierrez S, Choi JY, Rosen V, Stein JL, van Wijnen AJ, Stein GS, Lian JB, Ryoo HM. Transient upregulation of CBFA1 in response to bone morphogenetic protein-2 and transforming growth factor beta1 in C2C12 myogenic cells coincides with suppression of the myogenic phenotype but is not sufficient for osteoblast differentiation. J Cell Biochem 1999; 73:114-25. [PMID: 10088730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The bone morphogenetic protein (BMP)-2 is a potent osteoinductive signal, inducing bone formation in vivo and osteoblast differentiation from non-osseous cells in vitro. The runt domain-related protein Cbfa1/PEBP2alphaA/AML-3 is a critical component of bone formation in vivo and transcriptional regulator of osteoblast differentiation. To investigate the relationship between the extracellular BMP-2 signal, Cbfa1, and osteogenesis, we examined expression of Cbfa1 and osteoblastic genes during the BMP-2 induced osteogenic transdifferentiation of the myoblastic cell line C2C12. BMP-2 treatment completely blocked myotube formation and transiently induced expression of Cbfa1 and the bone-related homeodomain protein Msx-2 concomitant with loss of the myoblast phenotype. While induction of collagen type I and alkaline phosphatase (AP) expression coincided with Cbfa1 expression, Cbfa1 mRNA was strikingly downregulated at the onset of expression of osteopontin (OPN) and osteocalcin (OCN) genes, reflecting the mature osteoblast phenotype. TGF-beta1 treatment effectively suppressed myogenesis and induced Cbfa1 expression but was insufficient to support osteoblast differentiation reflected by the absence of ALP, OPN, and OCN. We addressed whether induction of Cbfa1 in response to BMP-2 results in the transcriptional activation of the OC promoter which contains three enhancer Cbfa1 elements. Transfection studies show BMP-2 suppresses OC promoter activity in C2C12, but not in osteoblastic ROS 17/2.8 cells. Maximal suppression of OC promoter activity in response to BMP-2 requires sequences in the proximal promoter (up to nt -365) and may occur independent of the three Cbfa sites. Taken together, our results demonstrate a dissociation of Cbfa1 expression from development of the osteoblast phenotype. Our findings suggest that Cbfal may function transiently to divert a committed myoblast to a potentially osteogenic cell. However, other factors induced by BMP-2 appear to be necessary for complete expression of the osteoblast phenotype.
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Affiliation(s)
- M H Lee
- Department of Biochemistry, School of Dentistry, Kyungpook National University, Taegu, Korea
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Abstract
Verruciform xanthoma is an uncommon benign lesion of unknown aetiology and pathogenesis. Two cases of verruciform xanthoma are presented together with an immunohistochemical and ultrastructural study. One case co-occurred with an odontogenic keratocyst which, to our knowledge, has not been previously reported, and another case occurred on masticatory mucosa with an asymptomatic, granular, exophytic lesion causing a cleft-like gingival recession. In an immunohistochemical study using antibodies to macrophage (CD 68[KP1]), alpha-1-antitrypsin, vimentin, desmin, keratin, neuron-specific enolase (NSE) and S-100 protein, the characteristic foam cells of verruciform xanthoma showed strong positive staining for CD 68[KP1] and vimentin and weak positive staining for alpha-1-antitrypsin, while the other antibodies were negative. As in previous studies, S-100 protein positive dendritic cells were detected in lesional connective tissue. In addition, the ultrastructural findings revealed characteristics of macrophages containing varying sized lipid vacuoles and degenerating epithelial cells. These findings support the concepts that the foam cells in verruciform xanthoma are of monocyte-macrophage lineage and that the epithelial degeneration from uncertain causes may be related to the pathogenesis of the lesion.
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Affiliation(s)
- H I Shin
- Department of Oral Pathology, School of Dentistry, Kyungpook National University, Taegu, Korea
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Nagai N, Yamachika E, Nishijima K, Inoue M, Shin HI, Suh MS, Nagatsuka H. Immunohistochemical demonstration of tenascin and fibronectin in odontogenic tumours and human fetal tooth germs. Eur J Cancer B Oral Oncol 1994; 30B:191-5. [PMID: 7522711 DOI: 10.1016/0964-1955(94)90090-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The distribution of tenascin and fibronectin (plasma fibronectin) was studied immunohistochemically in ameloblastomas, ameloblastic fibromas and ameloblastic carcinomas, as well as in tooth germs using monoclonal antibodies. Tenascin is an extracellular matrix molecule that was shown to be enriched in the embryonic mesenchyme surrounding the budding epithelium in various organs, including the tooth. Tenascin was strongly expressed in the basement membrane zone of the ameloblastomas and in the early tooth germ and the dental lamina, but not in the dental follicle. The expression of tenascin in the ameloblastic fibroma was seen in the basement membrane of the epithelial islands throughout the stromal tissues. There were clear differences in fibronectin expression in the follicular ameloblastoma and ameloblastic carcinoma. The results suggest that tenascin and fibronectin are involved in epithelial mesenchymal interactions of the tooth germ and in odontogenic tumours.
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Affiliation(s)
- N Nagai
- Department of Oral Pathology, School of Dentistry, Okayama University, Japan
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Abstract
In order to evaluate the effects of a topical application of homologous fibronectin on the healing of skin wounds, we made 2 excisional wounds on the back skin of each rat, applied ointment with or without fibronectin purified from citrated homologous plasma, and evaluated the effect according to wound size and microscopic findings. Excised lesions treated with carrier alone, but the difference was significant only in the early phase of wound healing, 2 and 3 days, according to wound size and microscopic changes. A significant decrease in wound size could be found in both groups, treated with ointment containing and not containing fibronectin, between day 4 and 9 when wound contraction was a major contributor to wound closure. Therefore it can be concluded that topical application of fibronectin has a beneficial effect on wound healing during its early phase, but no significant influence on wound contraction.
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Affiliation(s)
- J S Jo
- Department of Biochemistry, School of Medicine, Kyungpook National University, Taegu, Korea
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Shin HI. [Patient care for the long-term illness (IV). Complications during hemodialysis]. Taehan Kanho 1988; 27:14-8. [PMID: 3144624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Ryu JS, Oh WS, Choi SC, Shin HI, Chung C. [A case report of the ameloblastic fibro-odontoma]. Taehan Chikkwa Uisa Hyophoe Chi 1987; 25:1061-8. [PMID: 3507455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Lee SH, Kim JS, Kim SH, Park JY, Choi TH, Kwack DH, Shin HI. [An experimental and clinical study of reimplantation of frozen autogenous mandibular bone]. Taehan Chikkwa Uisa Hyophoe Chi 1987; 25:465-77. [PMID: 3474324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Shin HI. [Education nursing class; hemodialysis]. Taehan Kanho 1982; 21:79-82. [PMID: 6916928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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